Contemporary Pediatrics Cases

A healthy 14-year-old girl who is an avid violin player is brought to the office for evaluation of facial acne. The examination notes a rash on her left neck that has been present for a few years. The patch is mildly tender and itchy but otherwise asymptomatic.

Parents of a 6-year-old boy bring him to your office for urgent consultation for a rash that blossomed on his trunk and extremities 2 weeks ago following an upper respiratory infection and that shows no sign of improving. What’s the diagnosis?

Two siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.

A healthy 10-year-old boy is brought to your office by his worried father for evaluation of an asymptomatic birthmark on his left ankle. It has grown proportionately and does not cause pain or interfere with normal function. What’s the diagnosis?

A previously healthy 8-month-old girl presented to the emergency department with fever and increased work of breathing. She was hospitalized for hypoxia attributed to community-acquired pneumonia, treated with ceftriaxone, and weaned to room air over several days. On the morning of planned discharge, she was noted to have had persistently elevated blood pressures for the past 12 hours.

The mother of a 7-year-old girl brings her to the office for evaluation of eczema. On review of symptoms, she mentions concern about a bald spot above her daughter’s right ear, noticeable when she braids her hair.

An 8-year-old boy presents to the emergency department (ED) with acute onset of twitching. The child began experiencing uncontrollable tics involving his bilateral upper extremities and shoulders 2 hours prior to presentation, with no associated loss of consciousness.